Comparing cancer survival among the European countries is important to evaluate the performance of Health Care Systems and reduce disparities in access to diagnostic and treatment facilities. The EUROCARE project compares survival in Europe since the nineties. The EUROCARE- 4 analysed 2 690 922 adult cancer cases from 83 cancer registries in 22 European countries, diagnosed in 1995-1999, and followed to December 2003. For each cancer site, the European area weighted mean and age-standardised country-specific observed and relative survival by age and sex is computed. Within-country variation in survival is analysed for selected cancers. Survival for most solid cancers, whose prognosis depends largely on stage at diagnosis (breast, colorectal, stomach cancers, and skin melanoma), was highest in Finland, Sweden, Norway, and Iceland, lower in the UK and Denmark, and lowest in the Czech Republic, Poland and Slovenia. France, Switzerland and Italy generally had good survival, slightly below that of the Northern countries. For all cancers, five-year survival was very variable also for the different sites mix. Continuing to monitoring cancer survival in Europe is important to reduce differences in access to diagnostic and therapeutic facilities. After publication of EUROCARE results, UK and Denmark developed a National cancer plan to improve time of diagnosis and treatment.